October 7th 2023 mass casualty incident in southern Israel: lessons for emergency preparedness and management.

Background: Mass Casualty Incidents (MCIs) pose significant challenges for healthcare systems. While policies are typically crafted based on past experiences, the lessons learned from each incident play a crucial role in enhancing emergency preparedness. On October 7th, 2023, Israel came under the largest terror attack in its history.

Randomised immunogenicity trial comparing 2019-2020 recombinant and egg-based influenza vaccines among frequently vaccinated healthcare personnel in Israel.

Objectives: Trivalent inactivated influenza vaccine effectiveness was low in a prospective cohort of healthcare personnel (HCP) in Israel from 2016 to 2019. We conducted a randomised immunogenicity trial of quadrivalent recombinant influenza vaccine (RIV4) and standard-dose inactivated influenza vaccine (IIV4) among frequently and infrequently vaccinated previous cohort participants.

Methods: From October 2019 to January 2020, we enrolled and randomly allocated HCP from two Israeli hospitals to receive IIV4 or RIV4.

Outcomes of in-hospital cardiac arrest managed with and without a specialized code team: A retrospective observational study.

Background: In-hospital cardiac arrest (IHCA) still has a poor prognosis despite medical advancements in recent decades. Early and high-quality cardiopulmonary resuscitation (CPR), as well as good teamwork, are important prognostic factors. There are no clear guidelines regarding the composition of a dedicated hospital CPR team.

Adherence to monitoring of patients treated with amiodarone: a nationwide study.

Objective: The aim of this study was to assess the adherence to monitoring guidelines regarding amiodarone treatment.

Methods: This is a retrospective cohort study of data recorded in Clalit Health Services, the largest healthcare organization in Israel. Included were individuals aged >18 years; who were prescribed amiodarone and had a documented purchase of this drug, for a minimum of 200 consecutive days; and who had less than a 100-day gap between two consecutive purchases during 2013-2021.

Exploring the association between serum phosphate levels and mortality in patients hospitalized with infectious diseases: a nationwide study.

Objective: The purpose of this study was to examine associations of serum phosphate levels with mortality, target organ damage and length of hospital stay in adults with infectious diseases hospitalized outside of the intensive care unit.

Methods: This nationwide retrospective cohort study comprised patients admitted with infections, to medical and surgical departments in eight tertiary hospitals during 2001-2020. The main exposure variable was the first serum phosphate levels at admission (up to 1 week).

Shining Light on Photobleaching: An Artifact That Causes Unnecessary Excitation Among Pathologists.

Context.—: Photobleaching artifact occurs when fluorescence intensity decreases following light exposure. Slides stained with fluorescent techniques may be stored in the dark until primary diagnostics.

Emergency Department Admission Rates, Waiting Times, and Mortality: An Observational Study in the Tertiary Center Most Proximal to Gaza During a Military Conflict.

Objectives: Military conflicts may be ongoing and encompass multiple medical facilities. This study investigated the impact of a military conflict ("Protective Edge" PE) on emergency department (ED) function in a tertiary medical center.

Methods: Visits to the ED during PE (July-August 2014) were compared with ED visits during July-August 2013 and 2015 with regard to admission rates, waiting times and 30-d mortality.

Beating the clock: Reduced time to first antibiotic dose administration following an audit and feedback intervention.

Objective: Quality improvement interventions and policy revisions have been shown to improve clinical practice and patient outcomes. This study evaluated an intervention to shorten the time from the first antibiotic dose ordering to its administration in patients hospitalised with bacterial infections.

Methods: An intervention consisting of a weekly email report to nurse and physician leaders in hospital departments was introduced.

The role of lactate dehydrogenase in hospitalized patients, comparing those with pulmonary versus non-pulmonary infections: A nationwide study.

Background: Lactic dehydrogenase reflects target organ damage, and is associated with mortality in patients with infectious diseases.

Objective: The purpose of this study was to examine associations of serum lactic dehydrogenase levels with mortality, target organ damage and length of hospital stay in adults with pulmonary and non-pulmonary infections.

Methods: This nationwide retrospective cohort study comprised patients admitted with infections, to medical and surgical departments in eight tertiary hospitals during 2001-2020.

Implementing a screening algorithm for early recognition of sepsis in hospitalized children: a quality improvement project.

Sepsis is a leading cause of mortality in children. Utilizing a screening tool for early recognition of sepsis is recommended. Our centre had no screening tool for sepsis nor a standardized protocol for sepsis management.

[DIAGNOSTIC ERROR: PREDICTING THE SEVERITY OF HARM].

Introduction: Many studies report that the most common cause for malpractice claims is "diagnostic error including delayed/ missed/ wrong diagnosis".

Aims: To identify factors associated with severe harm and mortality in malpractice claims due to delayed/wrong diagnosis.

Methods: Review of records of malpractice claims against Clalit Health Services due to delayed/failed diagnosis in 2010-2019.

The appropriateness of the decision to quarantine healthcare workers exposed to a severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-positive coworker based on national guidelines.

Objective: To examine the appropriateness of the decision to quarantine healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19).

Design: Retrospective cohort study.

Setting: A tertiary-care medical center in Israel.

Serum Albumin Levels as a Predictor of Mortality in Patients with Sepsis: A Multicenter Study.

Background: Low serum albumin is known to be associated with mortality in sepsis, as it reflects effects of nutrition, catabolism, and edema.

Objectives: To examine the association of albumin levels with in-hospital mortality in adults with sepsis, stratified by age groups.

Methods: This nationwide retrospective cohort study comprised patients admitted with sepsis to intensive care units in seven tertiary hospitals during 2003-2011.

Does training make a difference? Proficiency training in transfusion guidelines and its effect on red blood cell administration.

Background: Packed red blood cell (RBC) transfusion is a very common and frequently lifesaving therapeutic intervention, but a liberal transfusion policy may be associated with inferior patient outcomes. Various guidelines have been proposed to reduce the rate of unnecessary RBC transfusions. However, physicians' proficiency in such guidelines and the effect of training on RBC administration remain unknown.

Comparing Coronavirus Disease 2019 (COVID-19) Pandemic Waves in Hospitalized Patients: A Retrospective, Multicenter, Cohort Study.

Background: Coronavirus disease 2019 was first diagnosed in Israel at the end of February 2020. By the end of June 2021, there were 842 536 confirmed cases and 6428 deaths. Our aim in this multicenter, retrospective, cohort study is to describe the demographic and clinical characteristics of hospitalized patients and compare the pandemic waves before immunization.

Pain Management Evaluation in Maintenance Hemodialysis Patients.

Context: Pain is a common complaint in maintenance hemodialysis (MHD) patients, and it is often inadequately assessed and inappropriately treated.

Objectives: The study goal was to preliminarily evaluate pain management in MHD patients.

Methods: The study was a cross-sectional study conducted in 2013-2015.

National initiatives to promote quality of care and patient safety: achievements to date and challenges ahead.

Background: The quality of healthcare in Israel is considered "high", and this achievement is due to the structure and organization of the healthcare system. The goal of the present review is to describe the major achievements and challenges of quality improvement in the Israeli healthcare system. BODY: In recent years, the Ministry of Health has made major strides in increasing the public's access to comparative data on quality, finances and patient satisfaction.

P16, Ki67, P53, and WT1 Expression in Uterine Smooth Muscle Tumors: An Adjunct in Confirming the Diagnosis of Malignancy in Ambiguous Cases.

The diagnosis of uterine smooth muscle tumors is sometimes difficult, as these tumors may show worrisome features, suspicious for but not diagnostic of malignancy. The recommended immunohistochemical panel in this setting is currently under debate. In this study, we aimed to find a panel of immunohistochemical stains that would be helpful in determining the correct diagnosis in ambiguous uterine smooth muscle tumors, with an emphasis on investigating the possible usefulness of the WT1 antibody.

Patient-reported outcomes in maintenance hemodialysis: a cross-sectional, multicenter study.

Purpose: The aim of this study is to assess patient-reported outcome measures (PROMs) related to symptoms among maintenance hemodialysis patients (MHDp).

Methods: This cross-sectional study was conducted between 2013 and 2015, with 336 MHDp from five hospital hemodialysis units. It included a comprehensive assessment of the prevalence and intensity of 30 common dialysis-related symptoms quality of life and daily function of MHDp, by using the Dialysis Symptom Index (DSI), Quality of Life Short Form (KDQOL-SF), and demographic and clinical characteristics.

Effects of country of origin and wave of immigration on prevalence of schizophrenia among first and second-generation immigrants: A 30-year retrospective study.

Objectives: To compare the rates of schizophrenia among 1st and 2nd generation immigrants from two distinct backgrounds and across sequential periods of immigration.

Methods: A 30-years retrospective cohort study (187,184 individuals) of 1st and 2nd generation East-African immigrants (EAIs) and former Soviet-Union immigrants (FSUIs) who migrated to Israel between 1980 and 2012. EAIs were further divided according to waves of immigration.

Cardiovascular Disease and hospital admissions in African immigrants and former Soviet Union immigrants: A retrospective cohort study.

Background: Previous studies reported low prevalence of cardiovascular disease (CVD) despite an increasing prevalence of metabolic abnormalities in immigrants who moved from low CVD-risk regions to Western countries. Nevertheless, little is known about hospital admissions due to CVD in immigrants.

Methods: A retrospective cohort study of East Africa immigrants (EAI), Former Soviet Union immigrants (FSUI) and native-born Israelis (NBI) over 11-year period.

The impact of incorporating early rapid influenza diagnosis on hospital occupancy and hospital acquired influenza.

Objective: To assess the impact of incorporating early rapid influenza diagnosis on antimicrobial usage, nosocomial influenza transmission, length of stay, and occupancy rates among hospitalized patients.

Setting: A 1,100 bed tertiary-care hospital in southern Israel.

Methods: We implemented early rapid detection of influenza with immediate communication of results.

Atopic dermatitis and the metabolic syndrome: a cross-sectional study of 116 816 patients.

Background: Data regarding the association between atopic dermatitis (AD) and the metabolic syndrome are controversial.

Objective: To evaluate the prevalence of the metabolic syndrome and its components in a large group of patients with AD compared to a matched reference group.

Methods: A cross-sectional study of AD patients diagnosed by a dermatologist between 1998 and 2016, and a matched comparison group was performed.

Healthcare Service Utilization by 116,816 Patients with Atopic Dermatitis in Israel.

Understanding of the epidemiology and healthcare service utilization related to atopic dermatitis is necessary to inform the use of new treatments. This cross-sectional study was based on a group of patients with atopic dermatitis and a matched control group comprised of age- and sex- matched enrolees without atopic dermatitis from a large medical database. Healthcare service utilization usage data were extracted and compared between groups.